ERIE FAMILY HEALTH CENTER, INC; NPI #1952598468

Contact Information

ERIE FAMILY HEALTH CENTER, INC

4759 N KEDZIE AVE
CHICAGO, IL 60625-4420

Phone: 312-666-3494
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for ERIE FAMILY HEALTH CENTER, INC

NPI # 1952598468

LBN Legal business name ERIE FAMILY HEALTH CENTER, INC

Authorized official GABRIELA NORENA - (BILLING DEPARTMENT SUPERVISOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/28/2007

Last updated 06/02/2008 - About 18 years ago

Identifiers

IL	Other	1616827	BLUE CROSS BLUE SHIELD PROVIDER NUMBER
IL	Other	748480	MEDICARE PART B

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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